| NPI | 1730183567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX J6436) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR MD20981) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2012-08-16 |